T2＊磁共振灌注成像监测乳腺癌新辅助化疗疗效的应用研究  

Evalution of T2 ＊ --Weighted First Pass Perfusion MR Imaging in Assessment of Early Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

作　　者：汪晓红[1] 彭卫军[1] 唐峰[1] 顾雅佳[1] 毛健[1] 钱敏[1] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科复旦大学上海医学院肿瘤学系,上海200032

出　　处：《实用放射学杂志》2010年第9期1323-1327,共5页Journal of Practical Radiology

摘　　要：目的 探讨MR T2＊首过灌注成像（T2＊-PWI）在乳腺癌中的应用及早期监测乳腺癌新辅助化疗疗效的价值.方法 分析45例乳腺癌（均为浸润性导管癌）T2＊-PWI,比较19例按疗程随访的PWI结果（化疗前,2个疗程后）,统计乳腺T2＊-PWI成功率 并以负性增强积分、负性首过斜率及最大信号丢失率为分析数据源,观察分析新辅助化疗疗效.所有病例均经手术病理证实.结果 （1）乳腺癌的PWI成功率91.1%（41/45）,乳腺癌灶的负性灌注曲线表现为MR信号在短暂平台期后快速下降,较少或不出现信号强度恢复.（2）新辅助化疗中对治疗敏感的肿瘤负性灌注曲线渐趋平缓.比较化疗前,2疗程后肿瘤PWI负性灌注曲线测得的负性增强积分、负性首过斜率及最大信号丢失率（P〈0.01）,2组差异有显著统计学意义.结论 T2＊-PWI可用于评价、预测乳腺癌新辅助化疗的疗效.Objective To evaluate the value of T2 ＊ --weighted first--pass perfusion imaging（T2＊ --PWI） in predicting early re sponse to neoadjuvant chemotherapy（NAC）of locally advanced breast cancer（LABC）. Methods Forty--five patients with LABC （all vere invasive ductal carcinoma）proven by pathology underwent T2 ＊ --PWI. 19 cases were followed--up by MR T2 ＊ --PWI before and after the second cycle of treatment. The successful rate of MR T2 ＊ --PWI was evaluated. The therapeutic effect was also evalua- ted based on the results of the score of negative enhancement, negative first--pass slope and the loss rate of maximum signal intensi- ty. Results （1）Among 45 breast cancer,T2＊--PWI was successfully performed in 41 cases（91.1%）. Time--intensity curve showed sharp drop of MR signal intensity at the perfusion phase compared with pre--contrast baseline. （2）After 2 cycles of NAC, the nega- tive enhanced integration negative first--pass slope and maximum signal--loss ratio of LABC decreased significantly（P〈0.01 ）. The extent of signal intensity decreased and the slope of perfusion curve showed gradually even after therapy. Conclusion T2 ＊--PWI can provide a sensitive assessment of treating efficacy in breast carcinoma.

关 键 词：乳腺 乳腺癌 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]